AUDREY GENNIEL BREWER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054709

License Status

EXPIRED

Business

Title

First Name

AUDREY

Middle

GENNIEL

Last Name

BREWER

Business Name

AUDREY GENNIEL BREWER MD

Original Issue Date

06/26/2008

Effective Date

06/26/2008

Expiration Date

06/25/2011

City

CHICAGO

State

Zip

60611

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

07/19/2011